more on Tech: A 'hostile environment' for US natives????

[David Farber <dave () farber net>]

Begin forwarded message:

From: John Levine <johnl () iecc com>
Date: May 8, 2005 9:25:42 PM EDT
To: dave () farber net
Cc: Greg Skinner <gds () best com>
Subject: Re: [IP] more on Tech: A 'hostile environment' for US  
natives????


> I don't know much about the fields of medicine or law, but it seems
> that despite people from outside the US being hired to do those type
> of jobs in the US, US doctors and lawyers have not seen the type of
> job losses that US computer professionals have.

Just you wait.  Search for "medical tourism" and you'll find that
there is a large and rapidly growing market, in which people from
North America go to Thailand, Malaysia, India and South Africa (the
last specializing in plastic surgery) for medical procedures.  The
quality of the doctors is comparable to what they'd get at home,
there's a lot more nurses so they get a lot more attention, and the
facilities that cater to medical tourism are very plush and modern.
Even adding in international plane fares, you can get good care a
whole lot cheaper than at home.  I also gather that interpretation of
x-rays and the like is now routinely outsourced, with the images
scanned (if they're not digital to start with) and sent to qualified
doctors in Asia who e-mail back the results.


> A major difference between the practice of law and medicine
> vs. software engineering (for example) is that you need to get a
> license to do the prior two on a professional level.

I don't think that's it.  If it were, hairdressers and exterminators
would all be rich.

In the particular case of medicine, I think it's that most of medicine
requires the doctor and the patient to be physically in the same place
for an examination or a procedure.  To the extent that telemedicine is
possible, it's happening.

Law is a more interesting case.  I think there's two issues there.
One is that US law is unlike law anywhere else in the world, due to
our having a common law system that forked from England earlier than
anyone else, and a unique federal system with overlapping federal and
state jurisdiction.  There's no reason people in other countries
couldn't learn our law, but in practice they don't for the same reason
that few law students here know anything about the legal system in,
say, Germany or India.  On the other hand, most of the work that law
firms do is handled by paralegals and junior associates who don't do
anything that needs a license, and other than meetings with clients
and appearances in court, it all strikes me as stuff that could easily
be done a thousand miles or 10,000 miles away.

At the moment I think the main thing saving lawyers is that large
clients are not particularly price sensitive.  Little jobs like
writing a will aren't worth the overhead of moving offshore, big jobs
tend to have enough at stake that the client is much more interested
in winning the case than in minimizing costs.  But who knows how much
longer that will last.  If nothing else, law firms could increase their
profits quite a lot by using offshore associates whom they pay $1/hr
rather than Americans whom they pay $20/hr, and billing the client
the same $90/hr either way.

Regards,
John Levine, johnl () iecc com, Primary Perpetrator of "The Internet for  
Dummies",
Information Superhighwayman wanna-be, http://www.johnlevine.com, Mayor
"I shook hands with Senators Dole and Inouye," said Tom, disarmingly.



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